Professional Coder

Axelon Services Corporation; Newark (NJ); On-site; USD 60,000 - 75,000; Full time

Job summary

Axelon Services Corporation is seeking a skilled medical coder in Newark, NJ. This role involves reviewing and analyzing medical record documentation for accuracy and compliance with ICD-9/ICD-10 guidelines.

Applicants should possess RHIT certification or similar credentials along with at least two years of experience in medical coding. Strong knowledge of coding systems and excellent communication skills are essential. Join a team focused on continuous improvement and quality assurance in healthcare documentation.

Qualifications

• Current RHIT or Certified Professional Coder designation required.
• 2+ years of Medical Coding experience necessary.
• Minimum of 2 years’ experience in Health Insurance/quality chart audits required.

Responsibilities

• Review medical records for compliance with coding guidelines.
• Support the collection of coding improvement tools.
• Actively participate in program improvement discussions.

Skills

CPT-4 coding

ICD-9/ICD-10 coding

Medical terminology

Team communication

Education

Bachelor's degree

Tools

Microsoft Word

Microsoft Excel

Job description

Summary

• This position is accountable for accurately reviewing, interpreting, auditing, coding, and analyzing medical record documentation for diagnosis accuracy, correct documentation, and Hierarchical Coding Condition (HCC) abstraction.
• Review may include inpatient, outpatient treatment, and/or professional medical services, according to ICD-9/ICD-10 CM coding guidelines and risk adjustment model regulations.
• This position supports Annual Commercial (ACA) and Medicare Advantage Risk Adjustment Data Validation Audits (RADV) along with the annual Risk Adjustment life cycle for the Medicare, Medicaid, and Commercial lines of business.

Responsibilities

• Understand and translate CPT, HCPC, ICD-9/ICD-10 codes for HCC abstraction.
• Review medical records for completeness, accuracy, and compliance with applicable coding guidelines and regulations.
• Identify, compile, and code member/patient data using ICD-9/ICD-10-CM and other standard classification coding systems.
• Support the collection and distribution of documentation and coding improvement tools for designated practice units as applicable.
• Support educational activities for internal stakeholders as necessary as a subject matter expert on coding review/guidelines.
• Actively participate and engage in program improvement discussions and activities.
• Maintain department productivity and accuracy standards.

Requirements

• Requires current Registered Health Information Technologies (RHIT) or Certified Professional Coder designation from the American Academy of Professional Coders or a Certified Coding Specialist, P from the American Health Information Management (AHIMA).
• Requires 2+ years of Medical Coding experience.
• Requires a minimum of 2 years’ experience in Health Insurance/quality chart audits and/or Utilization Review.
• Bachelor's degree preferred.

Preferred Skills

• Proficiency in the CPT-4, HCPC, ICD-9/ICD-10 coding.
• Knowledge of medical terminology of medical procedures, abbreviations, and terms.
• Knowledge of the healthcare delivery system.
• Ability to utilize a personal computer and applicable software (e.g., proficiency in Word and Excel).
• Effective verbal and written communication skills and the ability to work well within a team.
• Professional and ethical business practices, adherence to company standards, and a commitment to personal and professional development.
• Proven ability to exercise sound judgment and problem-solving skills.
• Proven ability to ask probing questions and obtain thorough and relevant information.